Insular Involvement Is Associated with QT Prolongation: ECG Abnormalities in Patients with Acute Stroke

<i>Purpose:</i> Aim was to assess the frequencies of electrocardiographic (ECG) abnormalities, including QT prolongation, in acute stroke patients and their association with stroke severity, stroke subtype and location, and cardiovascular risk factors. <i>Methods:</i> Prospectively, admission 12-lead ECG findings, stroke characteristics, cardiovascular risk factors, and potential QT-prolonging factors were collected in 122 consecutive patients with acute stroke. <i>Results:</i> Eighty-four patients (69%) had ECG abnormalities, most frequently ST changes in 34%, QT prolongation in 31%, and atrial fibrillation in 27% of them. Insular involvement and prior stroke independently predicted QT prolongation in small infarcts (insular involvement OR 0.12, 95% CI 0.02–0.74, p = 0.022; prior stroke OR 0.20, 95% CI 0.06–0.70, p = 0.012). <i>Conclusion:</i> Continuous ECG monitoring and assessment of the QT interval should be mandatory in patients with acute stroke.